Simulated cuspal deflection and flexural properties of high viscosity bulk-fill and conventional resin composites

Objectives: The purpose of this study was to investigate the simulated cuspal deflection and flexural properties of high viscosity bulk-fill and conventional resin composites. Methods: Seven high viscosity bulk-fill resin composites and eight conventional resin composites were used. Aluminum blocks (10 mm x 8 mm x 15 mm) with a mesio-occlusal-distal (MOD) cavity [4 (W) mm x 8 (L) mm x 4 (D) mm] were prepared and randomly divided into groups for different measurement techniques [micrometer vs CSLM] and further subdivided according to type of resin composite (high viscosity bulk-fill vs conventional resin composite). The simulated cuspal deflection resulting from the polymerization of resin composite bonded to a precisely machined MOD cavity within an aluminum block was measured with either a novel highly accurate submicron digimatic micrometer (MDH-25 M, Mitsutoyo, Tokyo, Japan) or a confocal laser scanning microscope (CLSM, VK-9710, Keyence, Tokyo, Japan) cuspal measurement method. In addition, flexural properties of tested resin composites were measured to investigate the relationship between simulated cuspal deflection and flexural properties. Scanning electron microscopy observation of tested resin composites was also conducted. Results: The simulated cuspal deflection of high viscosity bulk-fill resin composites was similar to that of conventional resin composites, regardless of measurement method. There were no statistically significant differences (p > 0.05) between the micrometer and CLSM cuspal measurement methods. There were statistically significant differences (p < 0.05) in flexural strength and elastic modulus depending on the material, regardless of the type of resin composite. Pearson correlation analysis did not show any statistically significant (p < 0.05) relationship between flexural properties and cuspal deflection. Conclusions: The results of this study indicate that high viscosity bulk-fill resin composites show similar cuspal deflection with bulk-filling techniques, to those shown by conventional resin composites with incremental filling techniques. Simulated cuspal deflection can be measured using either a micrometer or CLSM, but this experiment failed to show any relationship between the flexural properties and simulated cuspal deflection of resin composites. Significance: High viscosity bulk-fill resin composites produce the same level of cuspal deflection as a conventional incrementally filled resin composite.